28954 855 Brent Dr.
CITY OF SAN JOSE BUILDING DEPARTMENT
.APPLICATION FOR BUILDING PERMIT
1-9)T 12
Date---......-----......... -Permit No...._
Application is hereby ma3ja for a permit to.....Zal .. .............................................
'5
..Building
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a......—.....I--..story, Type----- -- - -------- -- . .. ... .......................... ............ --
) . .. .................. ............................................................................
at............9 .... "I ..4;'7?0__ -
to be occupied only as........... /'W.:......r5ft W .............................................
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $........
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances and all other laws
applicable to the construction, location, and use of buildings within the City of San Jose, will be complied with.
Owner..........._V.I.S TA..M.ANOR BUILDERS-)HG............AddressS
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By...........19LA...... -----_---------Address.SA/..
Contractor, Agent
Form 210-1
:-RECORD 'OF INSPECTION
Foundation------ .. F . 17 JLD
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